Individual ProviderMary IrwinPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address1555 Parkmoor Ave, San Jose, CA 95128-2407(408) 282-0402(707) 255-3300PECOS EnrollmentBased on the most recent information from CMS, provider Mary Irwin does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1821609314Provider TypeIndividualFull NameIrwin, MaryCredentialPTGenderFemaleSole ProprietorNoEnumeration Date8/10/2020Last Updated8/10/2020Contact InformationPractice LocationPractice Address1555 Parkmoor Ave, San Jose, CA 95128-2407Phone(408) 282-0402FaxUnlisted FaxMailing LocationMailing AddressPO Box 238, Napa, CA 94559-0238Phone(707) 255-3300Fax(707) 255-3527Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense23138California